Failure to Administer Medications in a Safe and Timely Manner
Penalty
Summary
The deficiency involves the facility’s failure to administer medications in a safe and timely manner for one resident. The resident was admitted for aftercare following explantation of a hip joint prosthesis and had diagnoses including infection and inflammatory reaction due to orthopedic prosthetic devices, acute embolism and thrombosis of deep veins, type II diabetes mellitus, and lumbosacral radiculopathy. The most recent MDS assessment documented that the resident was severely cognitively impaired, rarely or never understood, had no behaviors, and did not reject care. Physician orders included Seroquel (quetiapine fumarate) 12.5 mg via J-tube three times daily for bipolar disorder and ciprofloxacin 750 mg via J-tube every 12 hours for infection. Review of the medication administration audit report showed that on three consecutive days, the 9:00 A.M. doses of Seroquel and ciprofloxacin were administered several hours late: at 12:59 P.M., 12:17 P.M., and 12:32 P.M., respectively. In interview, the DON stated that nurses are expected to administer medications within one hour before or one hour after the scheduled time and confirmed that these medications were given outside the facility’s parameters for safe medication administration. Resident Council minutes from February and March documented resident complaints about medications being administered late. The facility’s policy on documentation of medication administration required that administration be documented immediately after it is given.
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